Pancreatic Cancer Clinical Trials

Pancreatic cancer clinical trials are offered in many parts of the word. These studies seek to establish the validity of new and possibly improved treatment options.

Clinical trials are, ideally, a part of a system in which a series of scientifically-controlled experiments shepherd a plausible medical agent, combination of agents or procedure through a process whereby the efficacy of the medical agent or procedure is established or not. In the U.S. this process is overseen by the Food and Drug Administration (“FDA”).

Until more recently, when fast-tracking has become more possible, the process of taking a potential agent from the biochemical stage through clinical trials to final FDA approval could take as long as 15 years. This process begins long before human testing. Generally, moving the process into human testing is predicated on successful animal results. It is then that the three primary phases of human testing begins. A phase I clinical trial with human subjects seeks to answer questions about whether a drug-agent is reasonably safe for use by humans. It also may seek to learn something of the biokinetics of the drug. And finally tries to establish what the maximum tolerated dose of the drug is. These are the only real aims of a phase I clinical trial, although researchers will, of course, be looking for subtle indications that the drug may show future promise.

Some fraction of phase I clinical trials will move on to the phase II, which seeks to answer the question as to whether the drug has, in fact, an apparent effect against the cancer in question (in our case pancreatic cancer). Many potential drug therapies go no further than phase II – as they show no real effect against pancreatic cancer. Successful phase II candidates move on to phase III clinical trials which seek to determine how the new therapy compares to existing standard therapies. Phase III clinical trials are the core measure of a potential new drug. Phase III clinical trials are controlled experiments whereby patients with similar characteristics are assigned to receive either the existing therapy or to receive the new therapy. After a time, the results of the arms of test are then compared. If the new agent shows similar or improved results as compared to existing therapy, (after another step or two) it is often approved for release by the FDA. There is even a phase IV to this process which has to do with after-approval monitoring of the new drug for side-effects, etc. as it makes its way into wider use.

The decision to participate in a clinical trial for pancreatic cancer is a big one and should not be taken lightly. At its very heart a clinical trial is an experiment. Consequently, clinical trials contain inherent risk-both active risks and passive risks. An example of an active risk might be encountering an unexpected side-effect of the drug. An example of a passive risk might include the clinical trial protocol which may call for being off all standard medical treatment for 28 days (which is not uncommon) before beginning the clinical trial. More many diseases, this may not patter much. But with pancreatic cancer, this kind of a rule may matter a great deal.

On the other hand, the prognosis of certain stages of pancreatic cancer may not be great. Some of the emerging treatments may appear to hold more promise than existing ones. Approaching the possibility of participating in a clinical trial in a carefully reasoned, intelligent manner, depending on circumstance, may be a smart personal decision.

There are many issues to consider. Am I a good candidate for a clinical trial? What emerging drug or combination of drugs looks to be promising? Is the clinical trial really (realistically) more promising than existing therapy? Which phase of clinical trial am I comfortable participating in? Which institution is hosting the clinical trial? What is their reputation? What is their location relative to mine? Which physicians will be involved? What support do I have?

And there are other issues – many of them. Probably more than you can come up with on your own. This is when a strong bond with your personal physician can be of great service to you. Be sure to ask for aid and guidance from your physician (and other health professionals) in helping sort through these kinds of complicated decisions regarding pancreatic cancer clinical trials.